CAJ | 학술논문

目的探讨婴幼儿脑内巨大囊肿型海绵状血管瘤的诊治要点.方法回顾性分析1998年3月至2006年11月收治的6例2岁以下脑内巨大囊肿型海绵状血管瘤的病史资料.全部患儿均采用开颅手术治疗,在显微镜下行病灶切除.结果全部6例中1例为多发患儿,我们只处理了有占位效应的病灶.患儿均获随访,随访6个月～8年,未见病灶原发部位再出血及复发,1例位于基底节近丘脑处作大部分切除,复查MRI仍可见少量紊乱血管团,术后半年行γ刀治疗.术前有神经功能障碍2例,术后恢复正常,有抽搐1例服药半年后停药,无抽搐发作.结论脑内海绵状血管瘤反复多次慢性出血,红细胞溶解所致囊肿,因有明显的占位效应,我们主张尽早手术,早期手术预后良好.
목적 탐토영유인뇌내거대낭종형해면상혈관류적진치요점.방법 회고성분석1998년3월지2006년11월수치적6례2세이하뇌내거대낭종형해면상혈관류적병사자료.전부환인균채용개로수술치료,재현미경하행병조절제.결과 전부6례중1례위다발환인,아문지처리료유점위효응적병조.환인균획수방,수방6개월～8년,미견병조원발부위재출혈급복발,1례위우기저절근구뇌처작대부분절제,복사MRI잉가견소량문란혈관단,술후반년행γ도치료.술전유신경공능장애2례,술후회복정상,유추휵1례복약반년후정약,무추휵발작.결론 뇌내해면상혈관류반복다차만성출혈,홍세포용해소치낭종,인유명현적점위효응,아문주장진조수술,조기수술예후량호.
Objective To discuss the diagnosis and treatment of intrcerebral giant cystic cavernous hemangiomas (CHH) in children.Methods Between Mar.1998 and Nov.2006,totally 6 children under 2 years old with CHH underwent treatment in out center and retrospective summarization and analysis was conducted in this study.The craniotomy was performed for lesion resection under the surgical microscope.Results Among all children one patient was found multiple lesions and the lesion with occupying effect was removed.The follow-up time in all cases ranged from 6 months to 8 years.Neither rehemorrhage nor recurrence was found in primary lesion.One case was treated by subtotal excision of lesion closed to halamic basal ganglia,and gamma knife radiotherapy was conducted in post-surgical 6 months due to less vascular mass in MRI imaging.Two cases with CHH presenting with neurological dysfunction recovered well after surgery.Another case with epilepsy presented well after management of anti-epilepsy drug.Conclusions Chronic bleeding and dissolution of erythrocytes result in the formation of CHH and significant occupying effect.The earlier excision usually brings better curative efficacies.